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Contact Information
Proposal Information
Organization Information
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Tell Us About Yourself
Name

Prefix
First Name
Last Name
Job Title
Phone
Area CodePhone Number
Email

Tell Us About Your Needs
Product or Service Interests
401(k)/DC Plan Recordkeeping
DB Plan Administration or Plan Design (Cash Balance and Traditional Defined Benefit)
DC Plan Administration or Plan Design (401k, Profit Sharing, etc.)
Nonqualified Plan Design
Retirement Plan Fiduciary Advisory [referred to external investment advisory partners]
Spectrum FinWell - Workplace Financial Wellness Program
Technology - (Cybersecurity Awareness; Microsoft Office 365 or Dynamics 365; Business Intelligence)
Other (please describe under Business Objectives)
Business Objectives

Tell Us About Your Company or Organization
Organization Name
Organization Website

Organization Address

Street Address
Street Address 2
City	State / Region
Postal Code	Country

Total Number of Employees

Please Review and Confirm
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Certification
I have the authority to request proposal for products, services, or solutions for the company or organization identified.